A major factor that affects systemic and pulmonary venous pressure is stressed blood volume (SBV). In turn, the left and right ventricular fillings and the regulation of the cardiac output through the Frank-Starling method are ascertained by the systemic and pulmonary venous pressure. Whether or not SBV is positively affected by the restriction of the sodium-glucose cotransporter-2 (SGLT2) is still not known. Patients with heart failure and reduced ejection fraction (HFrEF) were studied in order to find out what effects empagliflozin had on estimated stressed blood volume (eSBV) in comparison to placebo.

This study was conducted after a placebo-controlled, randomized, double-blinded trial started by a specialist was carried out. 10 mg of empagliflozin or corresponding placebo was given once every day to 70 patients for the duration of 12 weeks. Right heart catheterization was performed on patients at rest as well as during exercise at baseline and follow-up. A newly presented analytical approach on the basis of the invasive hemodynamic assessment helped in ascertaining the outcome which happened to be an alteration in the eSBV after the 12 weeks treatment with empagliflozin throughout the entirety of the time period.

The researcher’s randomized patients with HFrEF (mean age 57 years and mean ejection fraction 27%) with 47 patients (71%) who were getting diuretics. Over the entire time period of the treatment, we found a notable decrease (9%) in eSBV due to empagliflozin in comparison to placebo (−198.4 mL, 95%CI: −317.4; −79.3, p=0.001). There was a noteworthy association between the decrease of eSBV due to empagliflozin and the decrease in PCWP (R= ̶ 0.33, p<0.0001). The researchers found that the empagliflozin’s effect was rather steady throughout the investigation of the subgroup.

Patients with stable chronic HFrEF during submaximal exercise showed a noteworthy decrease in stressed blood volume following 12 weeks of treatment with empagliflozin in comparison to placebo.